摘要
目的 探讨近期皮质下小梗死(recent small subcortical infarct, RSSI)患者脉络膜厚度与脑白质高信号(white matter hyperintensities, WMH)的关系。方法 回顾性纳入2021年11月至2023年5月常州市第二人民医院神经内科住院的RSSI患者83例,根据脑室旁白质高信号(periventricular white matter hyperintensity, PWMH)分为无-轻度1组46例,中重度1组37例;又根据深部白质高信号(deep subcortical white matter hyperintensities, DWMH)分为无-轻度2组40例,中重度2组43例。所有患者行头颅磁共振成像、光学相干断层成像检查。利用软件半自动分割脉络膜并测量厚度,按照WMH部位分为PWMH及DWMH,分析脉络膜厚度与不同部位WMH的关系。结果 中重度2组年龄、吸烟、高血压、DWMH体积明显高于无-轻度2组,脉络膜厚度明显薄于无-轻度2组,差异有统计学意义(P<0.05,P<0.01)。中重度1组年龄、吸烟、高血压、PWMH体积明显高于无-轻度1组,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示,年龄(OR=1.170,95%CI:1.064~1.287,P=0.001)、高血压(OR=4.533,95%CI:1.215~16.914,P=0.024)、脉络膜厚度(OR=0.953,95%CI:0.931~0.975,P=0.001)是DWMH等级的独立危险因素。结论 RSSI患者脉络膜厚度变化是DWMH病变程度的独立影响因素。DWMH病变越严重,脉络膜厚度越薄。
Objective To investigate the relationship between choroidal thickness and white matter hyperintensity(WMH) in patients with recent subcortical small infarct(RSSI).Methods A total of 83 RSSI patients hospitalized in our hospital from November 2021 to May 2023 were enrolled, and according to paraventricular WMH,they were divided into no to mild lesion group 1(46 cases) and moderate to severe lesion group 1(37 cases),and based on deep WMH,40 of them were assigned into no to mild lesion group 2 and 43 cases into moderate to severe lesion group 2.All patients underwent cranial MRI for paraventricular WMH and deep WMH,and optical coherence tomography to measure choroid thickness by semi-automatic segmentation.The relationship between choroidal thickness and WMH at paraventricular and deep parts was analyzed.Results Significant advanced age, higher proportions of smoking and hypertension, and larger volume of deep WMH,while obviously thinner choroid thickness were observed in the moderate to severe lesion group 2 than the no to mild lesion group 2(P<0.05,P<0.01).While the moderate to severe lesion group 1 had older age, higher smoking and hypertension ratios, and higher volume of paraventricular WMH when compared with the no to mild group 1(P<0.05,P<0.01).Multivariate logistic regression analysis showed that age(OR=1.170,95%CI:1.064-1.287,P=0.001),hypertension(OR=4.533,95%CI:1.215-16.914,P=0.024),and choroidal thickness(OR=0.953,95%CI:0.931-0.975,P=0.001) were independent risk factors for deep WMH grade.Conclusion Changes in choroidal thickness in RSSI patients are independent influencing factors for severity of deep WMH lesions.The more severe the deep WMH lesion is, the thinner the choroidal thickness.
作者
崔凯迪
张敏
恽文伟
章晨焱
Cui Kaidi;Zhang Min;Yun Wenwei;Zhang Chenyan(Department of Neurology,Changzhou Second People's Hospital,Nanjing Medical University,Changzhou 213000,Jiangsu Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2024年第9期1065-1068,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
常州市十四五卫生健康高层次人才项目(2022CZBJ055)
南京医科大学常州医学中心临床研究项目(CMCC202207)。
关键词
脑梗死
脉络膜
磁共振成像
脑白质高信号
brain infarction
choroid
magnetic resonance imaging
white matter hyperintensity